Ahead of Print: Intracerebral Abscess with ICP Monitor

Background and Importance: Intracranial pressure (ICP) monitoring is a mainstay in the management of traumatic brain injury. Large investigations have validated the safety and efficacy of ICP monitors in comatose patients. Clinically relevant infections are extremely rare and cerebral abscess has never been reported using the Camino device. We describe an exceptional case of a life-threatening intracerebral abscess from an intraparenchymal ICP monitor.

Clinical Presentation: A 35 week old child required 7 days of ICP monitoring following a fall from a two-story window. His hospital course was complicated by severe airway edema treated, in part, with high dose corticosteroid therapy for a total of 10 days. Two weeks later the patient acutely deteriorated due to a large intracerebral abscess under the previous ICP monitor site. Urgent craniotomy with evacuation of the abscess was performed on two separate occasions. Cultures grew methicillin-sensitive Staphylococcus aureus which was treated with long-term antibiotics. At 3-month follow-up the patient was meeting age-appropriate milestones without focal deficits.